Gastrinoma excision for cure. A prospective analysis.
The role of surgery in the treatment of gastrinoma is unclear. The purpose of this study was to determine prospectively the surgical cure rate using a controlled clinical trial. Eleven patients who fit the entry criteria underwent abdominal exploration and attempted tumor resection for cure. A historical control group was used for comparison. Cure was defined as: (1) normal serum gastrin level, (2) no response to intravenous secretin, (3) no symptoms when antisecretory medications are stopped, and (4) no tumor recurrence on follow-up examination. Tumors found in both groups tended to be small (1.5 cm vs. 2.2 cm), multiple (71% vs. 40%), and in lymph nodes (70% vs. 70%). All tumors identified were located anatomically within the gastrinoma triangle. Tumors were found in 10 of 11 patients (91%) in the study group, and significantly more patients had their tumors excised for cure as compared to controls (82% vs. 27%, p less than 0.05). The current prospective cure rate for gastrinoma is higher than previously appreciated and tumors within lymph nodes do not preclude curative resection.
Howard
T J
TJ
Department of Surgery, UCLA Center for the Health Sciences.
Zinner
M J
MJ
Stabile
B E
BE
Passaro
E
E
D000328:Adult; D000368:Aged; D004379:Duodenal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects; D015408:Gastrinoma / Q000473:pathology / Q000601:surgery*; D005755:Gastrins / Q000097:blood; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011446:Prospective Studies; D012074:Remission Induction
D005755:Gastrins